Matching Items (3)
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- All Subjects: Electronic Health Records
- All Subjects: Chronic Pain
- Creators: Doebbeling, Bradley
- Member of: Barrett, The Honors College Thesis/Creative Project Collection
Description
This thesis concerns the adoption of health information technology in the medical sector, specifically electronic health records (EHRs). EHRs have been seen as a great benefit to the healthcare system and will improve the quality of patient care. The federal government, has seen the benefit EHRs can offer, has been advocating the use and adoption of EHR for nearly a decade now. They have created policies that guide medical providers on how to implement EHRs. However, this thesis concerns the attitudes medical providers in Phoenix have towards government implementation. By interviewing these individuals and cross-referencing their answers with the literature this thesis wants to discover the pitfalls of federal government policy toward EHR implementation and EHR implementation in general. What this thesis found was that there are pitfalls that the federal government has failed to address including loss of provider productivity, lack of interoperability, and workflow improvement. However, the providers do say there is still a place for government to be involved in the implementation of EHR.
ContributorsKaldawi, Nicholas Emad (Author) / Lewis, Paul (Thesis director) / Cortese, Denis (Committee member) / Jones, Ruth (Committee member) / Barrett, The Honors College (Contributor) / School of Politics and Global Studies (Contributor) / School of Human Evolution and Social Change (Contributor)
Created2013-05
Description
Electronic Health Records (EHRs) began to be introduced in the 1960s. Government-run hospitals were the primary adopters of technology. The rate of adoption continually rose from there, doubling from 2007 to 2012 from 34.8% to about 71%. Most of the growth seen from 2007 to 2012 is a result of the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act as part of the American Reinvestment and Recovery (ARRA) Act. $19 billion dollars were made available as part of these two acts to increase the rate of Health Information Technology (HIT), of which EHRs are a large part. A national health information network is envisioned for the end stages of HITECH which will enable health information to be exchanged immediately from one health network to another. While the ability to exchange data quickly appears to be an achievable goal, it might come with the cost of loss of usability and functionality for providers who interact with the EHRs and often enter health data into an EHR. The loss of usability can be attributed to how the EHR was designed.
ContributorsRobinson, Lillie Elizabeth (Author) / Doebbeling, Bradley (Thesis director) / Chiou, Erin (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05
Description
Over-prescription of opioid medications for chronic pain has been a major driver of the opioid abuse epidemic. Arizona has an opioid prescription rate of 50.7/100 persons annually, which is about the average US rate of 51.4/100 persons. Novel approaches to treat chronic pain and reduce opioid overuse are promptly needed. Using analysis of Medicaid prescribing data from across Arizona, Mountain Park Health Center was identified to have the lowest opioid prescribing rates among all Community Health Centers (CHC) in Arizona (14.2/100 persons) using analysis of Medicaid prescribing data from across Arizona. A healthy work culture of patient engagement, behavioral health integration into primary care (BHI), and active case management of SDoH issues were critical to successful opioid prescribing and management. In order to account for the complex systemic contributors towards opioid over-prescription, the underlying theoretical framework, positive deviance (PD), was used to uncover effective practices for notably low opioid prescribing. Focus groups of interdisciplinary provider teams (physicians, nurses, pharmacists, and behavioral health) were structured around the PD inquiry approach. Participants were asked about practice and culture factors that might foster or enable low-prescribing practices. Focus group interviews were audio-recorded and transcribed. Six critical themes were identified after extensive qualitative analysis of focus group transcripts: medication management; non-opioid pain management; service integration; preventive strategies; patient and family engagement; underlying factors (including medical/behavior comorbidity and socioeconomic factors). These findings illustrate that this CHC system has a culture which values a high level of care integration, internal systems, and community partnerships to address patient social determinants of health, and patient engagement and provider norms to provide alternatives to opioid prescription. Behavioral health integration into the care team is another key aspect of the culture. Our findings, if confirmed in other settings, could be useful in planning organizational interventions and training. We anticipate that efforts to implement and spread these approaches may be effective in decreasing opioid overuse, promoting health equity by targeting CHCs with room for improvement, and informing the larger research goals: to inform practice change and opioid prescribing across Arizona CHCs.
ContributorsCheng, Esther (Author) / Doebbeling, Bradley (Thesis director) / Daniulaityte, Raminta (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05